A touchy subject: perineal massage

Intimate massage ... Coconut and almond oils are best for perineal massage.

As your pregnancy nears its natural conclusion it’s normal to start thinking a lot about the birth. You’ll probably start wondering if there’s anything you can do to make it easier, and, well, not as painful as it could be. This is where perineal massage comes in.

The perineum is the skin and muscle between the vagina and anus, and is the area that stretches to let your baby through in childbirth. In some cases, it can tear naturally during the birth; other women need an episiotomy, which is where a doctor or midwife cuts it.

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So what’s the idea behind perineal massage? It’s believed that by massaging the area in the weeks leading up the birth, the skin will stretch and be better prepared for labour, reducing the risk of tearing or needing an episiotomy.

Of course, perineal massage doesn’t guarantee that you won’t tear – or everyone would do it! – but it can reduce your chances, according to research published in the American Journal of Obstetrics and Gynecology in 1998. The study, performed by a Canadian team of doctors led by Dr Michel Labrecque, found that 24.3 percent of first-time mums who practiced perineal massage gave birth with an intact perineum, compared to only 15.1 percent of the mums who didn’t do the massage. It was noted that the massage only seems to make a difference to mums who hadn’t given birth before, however.

It’s advised that perineal massage starts when you’re around 34 weeks pregnant, and that you do it once or twice a day. And if you’re a bit squeamish about it all, you can enlist your partner’s help!

24% of first-time mums who practiced perineal massage gave birth with an intact perineum, compared to 15% for those who didn't

As always, if you have any questions or concerns about anything related to your pregnancy, speak to your doctor or midwife.

Some women find that using a mirror so they can see what’s happening helps them have a better idea of what’s going on. Full-length mirrors give the best view.

Use almond or coconut oil, or a water-based lubricant such as KY Jelly, during the massage. Don’t use a petroleum-based lubricant.

How to do perineal massage

1. Sit in a comfortable position. It might take a while to find the best position for you, but some women find that sitting up on a bed with their legs spread and bent, their back supported by pillows, is best. If you’re having your partner do the massage, you can try lying on your side with your top leg bent a bit more than the bottom one.

2. To get used to the feeling, you can start by using your thumbs and fingers to massage the oil or lubricant around your perineum area.

3. Next, insert your thumbs into your vagina as deeply as possible. From the inside, apply pressure to your perineum, down towards your rectum and along the sides. Keep doing it until it starts to tingle or you even feel a slight burning,

4. When you feel the burning sensation, pause and breathe deeply, continuing to hold the pressure with your thumbs. Once the tingling or burning passes, you can stretch the area a little more, continuing to breathe deeply. Repeat once more.

5. As time passes and you continue the massage, it will take more pressure for you to feel the tingling or burning. Then, instead of using your thumbs, use two fingers – then three, and four.